Volume 40 | Issue 3 Article 10

1978

Blood Smears and the Use of Wright's Stain

Bruce R. Hoppe
Iowa State University

E. Duane Lassen
Iowa State University

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Recommended Citation
Hoppe, Bruce R. and Lassen, E. Duane (1978) "Blood Smears and the Use of Wright's Stain," Iowa State University Veterinarian: Vol. 40
: Iss. 3 , Article 10.
Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol40/iss3/10

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 Blood Smears and the Use of
Wright's Stain
Bruce R. Hoppe*
E. Duane Lassen, DVM, PhDt
A correctly made blood smear which is
properly stained and competently observed
has been called the single most valuable
laboratory examination in medicine.! Not
only is it simple to perform. but is also plays a
vital role in screening patients. in establishing
differential diagnoses. and in following the
history of a disease and the effect of treat-
ment. l It is. therefore. essential that the
preparation of good well-stained films be
mastered. The purpose of this paper is to
describe the proper techniques used in
making blood smears and in staining these
smears with Wright's stain. The mechanism
of action of Wright's stain is also discussed. It
is hoped that this paper will provide an aid to
those who wish to employ the blood smear as a
diagnostic tool.
Making the Blood Smear
Before any stained smear can be used for a
diagnosis. it is imperative that proper tech·
nique be used in smear preparation. If it is
poorly made. the stained smear will have no
value and worse still. may be seriously
misleading. 1.3
There are 2 procedures for making blood
smears: the coverglass method and the slide
method. Many hematologists feel that a well-
made coverglass smear is the more
satisfactory. Slides are less desirable for
differential counts because the large
leukocytes tend to be pushed to the edges of
the smear. while the smaller leukocytes
remain scattered throughout the smear.4
However. the coverglass method is a more
time-consuming and difficult technique to
perform. 1 The slide method is perhaps more
applicable to large animals practice where
blood smears may be prepared at the farm.
while the coverglass method is preferable
.Mr. Hoppe is a fourth year student in the College of
Veterinary Medicine. ISU.
tDr. Lassen is an Associate Professor of Veterinary
Pathology.ISU.
Issue No.3, 1978
under controlled conditions in the
laboratory. 5 The type of technique used is not
as important as the ability to produce well-
made smears. One should try both methods
and become proficient in the one found
easier.
Before either type of smear is made. it is
absolutely essential that scrupulously clean
glassware be used. The use of disposable slides
is the best way to ensure cleanliness. If it is
necessary to re-use slides. they should be
washed with soap and water. rinsed with hot
water followed by a distilled water rinse. and
stored in 95% alcohol in a closed container
until needed. 1
The direct smears should be made from
freshly drawn venous blood with no an-
ticoagulant or with EDTA anticoagulant. If
heparin is used. blood more than 1-2 hours
old should not be smeared because after this
period of time the anticoagulant causes
distortion of the white blood cells. 1.3.6
Coverglass Method l •6
1. Pick up a coverglass with one hand-
thumb and index finger on adjacent
corners.
2. Hold the coverglass over a large single
drop of blood and gently touch the
coverglass to the blood (the drop formed
by capillary attraction should be about
2-5 mm in diameter).
5. Pick up another coverglass in the other
hand in a similar fashion to the former.
4. Gently place the coverglass with the blood
diagonally on top of the other coverglass so
that the 2 superimposed form an oc-
tagonal shape. (This should be done
within 5-5 seconds after the drop of blood
has been picked up by the coverglass. for if
the blood is allowed to sit on the glass for a
long period of time. clumping of platelets
and white cells and rouleaux formation
will occur.)
5. Just before the spreading of the blood is
113
 complete, grasp the protruding corner of
the coverglass on top with the thumb and
index finger and separate these glasses in a
quick, steady, absolutely horizontal
motion. (Care should be taken to avoid
any squeezing together of the
coverglasses.) The coverglassess must be
separated with no deviation from the
horizontal.
6. Allow smears to dry.
Slide Method:3.5·6.7
1. Place a clean, grease· free slide on the
tabletop.
2. From a microhematocrit tube or other
source, carefully place a small drop of
blood (less than 3 mm in diameter) in the
middle of the slide approximately 1 em
from the end.
3. With thumb and index finger of one hand
hold the 2 edges of the slide on the other
end (farthest from the drop).
4. Hold the spreader slide with the thumb on
one edge and the other four fingers on the
other edge. (This spreader slide can be
similar to the slide on the table or may be
a special slide with a finely ground edge
and a slightly narrower width. However,
the spreader slide edge should be perfectly
smooth and free from chips.)
5. Place the end of the spreader slide in
contact with the slide on the table slightly
in front of the drop of blood. (The angle
between these 2 slides should be between
25° and 40°.)
6. Draw the spreader slide back toward the
drop of blood.
7. As soon as the spreader slide comes in
contact with the drop, it will fan out along
the width of the edge of the spreader slide.
If this does not occur, wiggle the spreader
slide a little until it does so. Be careful that
the blood does not get in front of the slide.
8. Keeping the spreader slide at a constant
angle, and the edge firmly against the
slide on the table, push the spreader slide
smoothly and rapidly over the entire
length of the slide. The spreader should be
pushed along with approximately the
same speed that one uses to strike a match.
9. Allow the smear to dry.
The most important requirement in
preparing a blood smear is that the mor·
114
phological elements are spread out intact or
with as little damage as possible. If the smears
are made correctly, the cells will be spread
smoothly and evenly with the red blood cells
lying flat and with the edges of the cells just
touching rather than overlapping. In the slide
method, a good smear is one in which there is
a gradual transition from the thick area to the
thin area and the thin area does not extend to
the end of the slide. 1.3
When producing a smear, the most
common source of error is using a drop of
blood that is too large in diameter (it should
be no greater than 3 mm).3.7.8 The smear can
still be made if the drop is too large by
touching the spreader slide to the drop so that
the width of the end is covered with blood,
removing the spreader from the drop, placing
the spreader on another portion of the slide,
and then continuing as before (from step 7).3
Another source for error is pushing the
spreader slide in a jerky motion and at a poor
angle. If the spreader is moved too slowly or
the angle used is too small, a thick film will be
produced and it will not be readable. If the
spreader is moved too rapidly or the angle is
too large, a thin film will be produced,
resulting in many of the leukocytes becoming
aggregated at the edges and in the tail. 3.6
Other causes of poor films are:
1. Hemolysis of cells due to moist fingers
touching the slide.
2. Scratches produced by rubbing moist films
immediately after preparation.
3. Holes occurring on the film due to grease
on the slide.
4. Holes in the film caused by flies feeding on
unfixed slides that are left unprotected. 7
After making the blood smear, the slides
should be dried. It is imperative that the
slides be dried completely before staining. If
the smears are fixed and stained immediately
after being prepared, the nuclear structure of
the white blood cells might undergo
denaturation resulting in disfigurement of the
nuclei and peripheral cell outline which can
seriously hamper precise differentiation. 7
The method by which drying should be
accomplished is disputed among
hematologists. One fact that is universally
agreed upon is that the drying should be
completed as soon as possible after the smear
is made. Prolonged drying results in
movement of water out of the red blood cells
Iowa State University Veterinarian
into the plasma leading to crenation of the
erythrocytes.I.J.5.6.7.8 Unfortunately, the
agreement ends there. Several authors suggest
hastening the drying process by waving the
slide rapidly in the air. I.3.6.8 Another author
suggests that an advantageous method to
facilitate drying is to use table fans which
blow unheated air over the slides. This author
also emphatically states that drying must be
performed without any artificial warming of
the slides (not even in sunlight). 7 Still another
author states that waving the film over a low
gas flame will hasten drying and improve
results. 5 This procedure is modified by
another individual who advocates the use of
slight heating with a gas flame only when
aqueous stains are to be applied to the smear.
(The smears are passed through the flame 3-4
times to achieve 120°C for a few minutes.)
Since the common blood stains are not
aqueous stains, this heat fixing of the smear is
not absolutely necessary.4
One must remember that it takes practice
to make good blood smears. Several smears
should be made on each sample and the best 2
used for staining. Time spent learning and
practicing to make good smears will be well
worthwhile. 1.3
Staining the Blood Smear
After the smear has been produced
properly, it is ready for Wright's staining.
The mechanism of Wright's staining is a proc-
ess in which both chemical and physical
factors playa role. During the staining proc-
ess, the stain in methanol is directly applied to
the smear. The alcoholic solution tends to
retain the dye, so that it is not absorbed to the
protoplasm of the cell. Tissue fixing by the
methanol occurs at this time. In order for the
stain to act chemically, it is necessary to force
the dye out of solution by the addition of
buffer which precipitates the stain. Upon
precipitation, the stain undergoes partial
dissociation into component parts, namely
eosin and the azure dyes.
The azure dyes have affinity for the
components of the cell which are acid in
character. Therefore, molecules such as DNA
and RNA will readily react with this molecule
and will acquire the dye's colorimetric
characteristics.
The precise role of eosin in the staining
process after partial dissociation from the
neutral stain is not agreed upon. One source
Issue No.3, 1978
states that the eosin molecule reacts readily
with cell components which are strongly
alkaline in a mechanism similar to the
azures. 5.12 Others state that not only does
eosin act as a stain, it also plays a role as a
fixative. 8 While still other authors insist that
eosin acts only as a buffer to allow Bernthsen's
methylene violet (a chemical produced from
methylene blue oxidation) to stain the ap-
propriate cellular components deeply red. 14
In any event, different cellular chemical
components are stained different colors with
the use of a single stain.3.5.8.11.12.14
There are various recipes for Wright's stain
application to blood smears. In fact, it is
unusual to find 2 different sources who agree
exactly upon the staining procedure.3.8.12.13
These variations in technique occur because
of variation in the behavior of the stain and
buffer and because of differences in film
thickness. 9 Wright's stain does not behave
uniformly because it is an alkaline solution in
which the concentrations of the dye are
continually changing due to the progressive
oxidizing action of the alkali. 4 The choice of
recipe is immaterial; the essential
requirement is consistency in the staining
technique. 10
Before staining, the slide can be fixed in
absolute methanol. This will increase the
blood cell's affinity for the stain. 5 This step is
important if the smears are to be kept for any
length of time before staining. 12 Although
many authors have stated various staining
recipes, the following is the staining schedule
for Wright's stain published by the Biological
Stain Commission:
1. Place 1 ml. of liquid Wright'S stain on the
blood film for 1-3 minutes, depending
upon its behavior (if it is a new batch of
stain, try 3 minutes; then modify as
needed).5
2. Add 2 mi. of phosphate buffer solution
adjusted to about pH 6.5 (distilled water
can be used, yet it is not advisable because
its pH changes from day to day and the pH
at this step is critical in the staining
procedure). II
3. After allowing this mixture to stand about
twice as long as the undiluted stain, flood
off the diluted stain with buffer solution
until the thin portions of the stained film
are pink.
The timing of each procedure may be
115
 modified to give better results from the
specific lot of stain used.
4. Stand the slides on end, air dry (or blot
very carefully).
If performed correctly, the red blood cells
should look yellowish-red and the neutrophils
should have dark purple nuclei, reddish-lilac
granules, and pale pink cytoplasm. II
Should one forget and leave the stain and
buffer solution on too long (20-30 minutes),
the cells may become over-stained. In such
cases the slide may be saved by soaking it in
rubbing alcohol for about 10 minutes and
allowing it to dry. It can then be stained in
the usual manner.3
There are faster and simpler methods to
perform Wright's staining. One method is the
Coplin Jar technique where the Wright'S stain
and buffer are kept in separate coplin jars
with screw lids. The slide is simply placed into
the jar of Wright's stain for 2-5 minutes and
then transferred directly to the jar containing
the buffer for 2-5 minutes. The slide is then
rinsed with buffer or distilled water and air
dried. This method's advantage over the
others is that less trouble is encountered with
precipitate on the stained film."
A coplin jar filled with methanol may be
used to fix the slides before staining.
However, utmost care must be taken to ensure
that this methanol remains free from water. It
must be covered when not in use and it must
be changed regularly. Anhydrous copper
sulfate can be added to decrease water uptake
by the methanol. 6
A number of quick stains are available
commercially which require only a few
seconds to obtain permanent preparation.
Generally these stains can be recommended
for use by the busy practitioner. Delicate
staining characteristics of specific granules
and other fine cytological features appear to
be less evident in films stained via these
methods."
The technique of producing a properly
made, properly stained blood smear is a vital
tool in diagnostic medicine. It is hoped that
this discussion has helped those who wish to
utilize this laboratory examination.
REFERENCES
1. Cartwright GE: Diagnostic Laboratory Hematology,
ed 4. New York, Grune and Stralton. 1968, pp.
48-80.
2. Block MH: Text·Atlas of Hematology. Philadelphia.
116
Lea and Febiger. 1976. pp. 20-42.
3. Seiverd CE: Hematologyfor Medical Technologists,
ed 4. Philadelphia. Lea and Febiger. 1972. pp.
38-98.
4. Wintrobe MM. et al: Clinical Hematology, ed 6.
Philadelphia. Lea and Febiger. 1967. pp. 380-450.
5. Schalm OW. et al: Vererinary Hematology, ed 3.
Philadelphia. Lea and Febiger. 1975. pp. 25-40.
6. Brown BA: Hematology: Principles and Procedures.
Philadelphia. Lea and Febiger. 1973. pp. 144-160.
7. Sandoz AG: Sandoz Atlas of Haematology, revised
by Erik Undritz. ed 2. Basel. Switzerland. Sandoz
Ltd .. 1973. pp. 38-80.
8. Simmons A: Technical Hematology. ed 2.
Philadelphia. J. B. Lippincott Co .. 1976. pp. 20-23.
9. Woodliff JH. Herrmann RP: Concise Hematology.
London. Edward Arnold Ltd .. 1973. pp. 33-40.
10. Huges· Jones NC: Lecture Notes on Hematology. ed
2. Oxford Blackwell Scientific Publications. 1973.
pp.40-52.
11. Clark G. et al: Staining Procedures. ed 3. Baltimore.
Williams and Wilkins Co .• 1973. pp. 131-150.
12. Archer RK: Hematological Techniques for Use on
Animals. Philadelphia. F. A. Davis. 1965. pp.
35-42.
13. Leavell BS. Thorup OA Jr.: Fundamentals of
Clinical Hematology. Philadelphia. W. B. Saunders
Co .. 1968. pp. 35-51.
14. Gurr E: Synthetic Dyes in Biology, Medicine and
Chemistry. New York. Academic Press. 1971. pp.
4-38.
* * *
continuedfromp.120-Alumni
Dr. Dennis J. Carr (ISU '56), a private
veterinary practitioner in Montfort,
Wisconsin. was elected chairman of the
Executive Board of the A VMA for 1978-79.
The Executive Board is the governing body of
the 29,607 -member national professional
association.
A native of Iowa. Dr. Carr is active in the
AABP. Wisconsin Cattlemen's Association.
and Wisconsin Agribusiness Council. He is
also president of Carr Farms. Inc. which owns
a beef and dairy farm.
Active for many years in local affairs, Dr.
Carr has served five 2 year terms on the
Montfort Town Board. as 4-H leader. and as
president of the Lay Council of St. Thomas
Catholic Church of Montfort.
Dr. Lloyd V. Fry (ISU '37) recently retired
from his position with Clemson University. as
chief of the South Carolina meat-poultry
inspection department. with which he had
been associated for the past 10 years. He
retired from the Army in June '68 as Colonel
with 30 years service. Looking forward to this
retirement, Dr. Fry and his wife will continue
to live in Columbia, S.C.
Iowa State University Veterinarian